U.S. patent application number 11/955806 was filed with the patent office on 2008-10-02 for bi-directional tourniquet.
Invention is credited to Patricia Thorpe.
Application Number | 20080243173 11/955806 |
Document ID | / |
Family ID | 39536986 |
Filed Date | 2008-10-02 |
United States Patent
Application |
20080243173 |
Kind Code |
A1 |
Thorpe; Patricia |
October 2, 2008 |
Bi-Directional Tourniquet
Abstract
A tourniquet comprising a band comprised of an elastic and
flexible material, the band having a width and a length, a first
end and a second end, and a first face and second face, where at
least a portion of the first face comprises hook-type fastener
means located within a third of the band at the first end, within a
third of the band at the second end, and within a middle third of
the band, and where the second face comprises loop-type fastener
means spanning the length of the second face.
Inventors: |
Thorpe; Patricia; (Iowa
City, IA) |
Correspondence
Address: |
BULLIVANT HOUSER BAILEY PC
1415 L STREET, SUITE 1000
SACRAMENTO
CA
95814
US
|
Family ID: |
39536986 |
Appl. No.: |
11/955806 |
Filed: |
December 13, 2007 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11940225 |
Nov 14, 2007 |
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11955806 |
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60901715 |
Feb 13, 2007 |
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60875087 |
Dec 13, 2006 |
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Current U.S.
Class: |
606/203 |
Current CPC
Class: |
A61B 17/1322
20130101 |
Class at
Publication: |
606/203 |
International
Class: |
A61B 17/00 20060101
A61B017/00 |
Claims
1. A tourniquet comprising: a band comprised of an elastic and
flexible material, said band having a width and a length, a first
end and a second end, and a first face and second face, wherein at
least a portion of said first face comprises hook-type fastener
means located within a third of said band at said first end, within
a third of said band at said second end, and within a middle third
of said band, and wherein said second face comprises loop-type
fastener means spanning the length of said second face.
2. The tourniquet of claim 1 whereby when said band is applied
across an appendage said band has length sufficient to encircle
said appendage bi-directionally, wherein when said band is applied
at said middle third across the appendage and extended from its
first end to encircle said appendage said loop-type fastener means
of the second face engages said hook-type fastener means of said
first face at said middle third, and wherein when said band is
subsequently extended from its second end to encircle said
appendage said loop-type fastener means of the second face at said
second end engages said hook-type fastener means of said first face
at said first end.
3. The tourniquet of claim 1 wherein said loop-type fastener means
of said second face of said first end engages said hook-type
fastener means of said middle third of said first face.
4. The tourniquet of claim 1 wherein said loop-type fastener means
of said second face of said second end engages said hook-type
fastener means of said middle third of said first face.
5. The tourniquet of claim 1 wherein said loop-type fastener means
of said first face of said second end engages said hook-type
fastener means of said second end of said first face.
6. The tourniquet of claim 1 further comprising a point of
attachment for said tourniquet on a garment.
7. The tourniquet of claim 6 wherein said tourniquet is affixed by
a method selected from the group consisting of stapling, gluing and
sewing.
8. The tourniquet of claim 6 wherein said tourniquet is affixed to
said garment at a region corresponding to an extremity.
9. The tourniquet of claim 6 wherein said tourniquet is affixed to
said garment at a region corresponding to the neck or head
region.
10. The tourniquet of claim 6 wherein said tourniquet is affixed to
said garment at a region corresponding to the torso.
11. The tourniquet of claim 1 further comprising a disc secured to
said tourniquet situated to apply focal pressure at a location of
bleeding or sub-surface blood flow.
12. A method for impeding hemorrhage at a site on the body by
applying a tourniquet to compress a vessel at a region to decrease
bleeding and blood flow to tissue supplied below that region, said
method comprising the steps of: a) applying a tourniquet at said
region, said tourniquet comprising a band comprised of an elastic
and flexible material, said band having a width and a length, a
first end and a second end, and a first face and second face,
wherein at least a portion of said first face comprises hook-type
fastener means located within a third of said band at said first
end, within a third of said band at said second end, and within a
middle third of said band, and wherein said second face comprises
loop-type fastener means spanning the length of said second face,
whereby said band is adapted to encircle said body part
bi-directionally, b) extending said band from its first end to
encircle said body part, whereby said loop-type fastener means of
the second face engage said hook-type fastener means of said first
face, and c) extending said band from its second end to encircle
said body part, whereby said loop-type fastener means of the second
face engage said hook-type fastener means of said first face,
whereby blood flow is decreased to tissue below said region.
13. The method of claim 12 wherein said loop-type fastener means of
said second face at said first end engages said hook-type fastener
means of said first face at said second end.
14. The method of claim 12 wherein said loop-type fastener means of
said second face at said first end engages said hook-type fastener
means of said first face at said middle third.
15. The method of claim 14 wherein said loop-type fastener means of
said second face at said second end subsequently engages said
hook-type fastener means of said first face at said first end.
16. The method of claim 12 further comprising a point of attachment
for said tourniquet on an article of clothing.
17. The method of claim 16 wherein said attachment point is
provided by hook-type fastener material secured to said
garment.
18. The method of claim 12 further comprising at least one disc
secured to said tourniquet situated to apply focal pressure at a
location of bleeding or sub-surface blood flow.
19. The method of claim 12 wherein said blood flow decrease is
partial.
20. The method of claim 12 wherein said blood flow decrease is
significant as assessed by Doppler flow measurement.
21. The method of claim 12 wherein said blood flow decrease is
substantially complete.
22. The method of claim 12 wherein said tourniquet is applied at a
region corresponding to an extremity.
23. The method of claim 12 wherein said tourniquet is applied at a
region corresponding to the neck or head region.
24. The method of claim 12 wherein said tourniquet is applied at a
region corresponding to the torso.
Description
PRIORITY
[0001] This invention is a continuation-in-part of U.S. patent
application Ser. No. 11/940,225, filed Nov. 14, 2007, which is a
continuation-in-part of U.S. Provisional Patent Application No.
60/901,715, filed Feb. 13, 2007, and a continuation-in-part of U.S.
Provisional Patent Application No. 60/875,087, filed Dec. 13, 2006,
the full disclosure of each of which applications are incorporated
herein in their entirety.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] This invention describes a versatile trauma tourniquet with
features permitting ease of application in the field, including
hook and loop along target securement areas.
[0004] 2. Description of Related Art
[0005] Wartime trauma from exploding devices and gunshot wounds
results in a high incidence of life and limb-threatening injuries.
Exsanguination from peripheral vascular injury is the primary
preventable cause of death in field trauma, and has been well
documented in literature regarding current war trauma.
[0006] Blood loss from non-fatal injuries to arms and legs also can
contribute to morbidity to kidneys, liver and other vital organs
due to hypotension. The loss of significant amounts of blood also
increases the rate of consumption of blood products from the blood
bank. Multiple extremity wounds can also complicate triage.
[0007] It is axiomatic that in combat, there is a "platinum 5
minutes" for major vascular injury. Even with quick triage, it
often takes hours to transport casualties off the battlefield, and
even if the distance is small, the hazardous nature of the forward
combat areas frequently prevents medical personnel from quickly
reaching the wounded. Hence the need for individual soldiers to
have a readily available tourniquet that is safe and effective.
[0008] Thus, despite the advances in modern medical care for the
battlefield, control of blood loss is the one immediate treatment
that can be applied to or by an injured soldier to decrease the
chance of organ injury, limb loss and death due to hemorrhage.
While deep vein thrombosis is of concern to soldiers and doctors in
the field, the more immediate danger is always focal vascular
injury and uncontrolled hemorrhage.
[0009] Despite long-established use in the medical field, the need
for new tourniquet technology is readily acknowledged. Hemorrhage
from extremity wounds is the leading cause of preventable death on
the battlefield, and tourniquets are the most viable option for
controlling life-threatening extremity hemorrhage in the tactical
phase of an operation. The evolution of tourniquet technology has
been a marked response to the realities of fighting in Iraq and
Afghanistan.
[0010] Tourniquet designs are varied. One recent patent, U.S. Pat.
No. 6,189,538, describes a non-pneumatic tourniquet for use in
treating deep vein thrombosis that includes a band having a first
end and a second end, wherein the first end and second end have a
structure for adjustably connecting to one another, shown as hook
and loop fasteners, and an adjustable disc made of a substantially
hard, non-compressible material connected to the band. Provided is
a method of treating deep vein thrombosis in which the thrombus
cannot be easily treated using a catheter.
[0011] United States Patent Application No. 2007/0005107 is
directed to a military emergency tourniquet, described as a
tourniquet for rapidly and easily reducing or stopping blood flow
to a limb. The tourniquet utilizes a hook and loop system and
includes a twistable strap, a base including two opposing entry
apertures and an exit aperture, a windlass and at least one
receiving loop.
[0012] U.S. Pat. No. 4,182,338, provides a pressure applying device
which prevents bleeding through needle puncture wounds by applying
pressure to the wound through an elastomeric appliance having a
blunt skin abutting surface held in place over the wound by
securing straps. The pressure applied by the device is sufficient
only to prevent bleeding through the wound and is not designed to
impede the subsurface flow of blood.
[0013] The most commonly used tourniquet, however, is still a
length of surgical tubing, the tourniquet used in phlebotomy.
However, such tubing does not function well for greater than 1-2
minutes because of the pain.
[0014] A continuing problem in the field, then, is the need for
rapid and safe protection for injuries to extremities. Vascular
injury alone can result in amputations from blood loss and
resulting ischemic muscle. The existing tourniquets available to
the combat infantryman, as well as medical personnel, vary in
degree of mechanical/clinical failure, often due to complicated and
time consuming application. In addition, certain designs are
painful, either inadequately or too adequately diminish blood-flow,
or are too bulky for routine field use.
[0015] Ease of use and effectiveness of the application are
critical to saving lives and limbs during those platinum 5 minutes,
yet according to the U.S. Army Institute of Surgical Research,
current technology has reportedly fostered misapplications,
intolerable pinching and skin/tissue damage, and has yet to take
effective control of leg injuries. Studies have shown that
tourniquet failure has revolved around several issues: 1)
inadequate mechanical advantage for tightening, 2) device failure
(i.e., breakage), and 3) intolerable pinching or circumferential
pain prior to pulse elimination. While one-handed tourniquet
technologies have even been able to minimize blood flow in the arm
to some extent, no one-handed technology has been found to be
successful in easily and reliably decreasing blood flow to the
lower extremity.
[0016] In April 2007, a comparative report from The Naval Sea
Systems Command was released to the public. This comprehensive
review of available field tourniquets compares 13 designs from 12
manufacturers. The comparison was conducted under rigorous clinical
standards, and the comments from failed applications provide great
insight into the application realities of tourniquet designs. They
also demonstrated the need for versatility and immediate
availability of a simple, strong and effective tourniquet in the
field.
[0017] There remains, then, a need for a life and limb saving
tourniquet, for military use and civilian use that can overcome the
obstacles of current technology.
SUMMARY OF THE INVENTION
[0018] This invention solves these problems with a vascular
tourniquet that is lightweight, not bulky, simple, fast and
effective to apply in a battle setting or civilian emergency
situations.
[0019] In one embodiment, the tourniquet comprises a band of
elastic and flexible material, having a width and a length, a first
end and a second end, and a first face and second lace, where at
least a portion of the first face comprises hook-type fastener
means located within a third of the band at the first end, within a
third of the band at the second end, and within a middle third of
the band, and where the second face comprises loop-type fastener
means spanning the length of the second face.
[0020] In one preferred aspect, the band is applied across a body
party, such as an appendage, head, neck or torso, the band being
adapted to encircle the body part bi-directionally. As the band is
extended from its first end to encircle the body part, the
loop-type fastener means of the second face engages the hook-type
fastener means of the first face, which may be at the second end,
where the body part has a large diameter, or, more typically, at
the middle third of the tourniquet.
[0021] Where the band has engaged at the middle third, the
tourniquet is further extended from its second end to encircle the
body part, and the loop-type fastener means of the second face
engage the hook-type fastener means of the first face at the first
end previously attached over the middle portion. The pressure
potential of the tourniquet to curtail bleeding is significantly
increased with the additional hook and loop attachment where the
application of the tourniquet comprises the loop-type fastener
means of the second face at the first end being engaged with the
hook-type fastener means of the middle third of the first face, and
the loop-type fastener means of the second face of the second end
being engaged with the hook-type fastener means of the first face
at the first end.
[0022] In an alternative embodiment of the invention, a point of
attachment is provided for the tourniquet on an article of
clothing, or garment, such as through providing hook-type fastener
material secured to the garment.
[0023] In a different embodiment, the tourniquet of the invention
may include use of a movable portable disc, which can be
selectively secured to the tourniquet and situated to apply focal
pressure at a specific location, such as a location of hemorrhage
or sub-surface blood flow.
[0024] With the tourniquet, a method for impeding blood flow to a
body part can be utilized by applying the tourniquet to compress a
vessel at a region to stop bleeding and also may partially decrease
blood flow to tissue supplied below that region. The method
comprises applying a tourniquet comprising a band comprised of an
elastic and flexible material, the band having a width and a
length, a first end and a second end, and a first face and second
face, where at least a portion of the first face comprises
hook-type fastener means located within a third of the band at the
first end, within a third of the band at the second end, and within
a middle third of the band, and where the second face comprises
loop-type fastener means spanning the length of the second face,
whereby the band is adapted to encircle the body part
bidirectionally. The tourniquet is applied at a specific region by
extending the band from its first end to encircle the body part,
whereby the loop-type fastener means of the second face engages the
hook-type fastener means of the first face and subsequently
extending the band from its second end to encircle the body part,
in the opposite direction, whereby the loop-type fastener means of
the second face engage the hook-type fastener means of the first
face, securely enough that blood flow is decreased to tissue below
the region.
[0025] In a preferred such method the loop-type fastener means of
the second face of the tourniquet at the first end engages the
hook-type fastener means of the middle third of the first face, and
then the loop-type fastener means of the second face at the second
end engages the hook-type fastener means of the first face at the
first end.
[0026] The tourniquet can also be sized so that it may go around
any part of the body that may be treatable by the application of
pressure to reduce hemorrhage or sub-surface blood flow, including,
but not limited to, the neck, head and torso, as well as upper and
lower extremities.
[0027] A given tourniquet may optionally be applied to a larger
body part than it was originally intended, by applying the
tourniquet so that the loop-type fastener means of the second face
at the first end engages the hook-type fastener means of the first
face at the second end, by-passing the middle third.
[0028] The methods of the invention permit various levels of
pressure, due to the elastic band, and the blood flow decrease may
be partial to substantially complete. The method of the invention
can be applied to decrease bleeding at the site and the distal
bloodflow as determined by Doppler flow measurements or pulse
palpitation.
[0029] These and other features and advantages of this invention
are described in, or are apparent from, the following detailed
description of various exemplary embodiments of the apparatus and
methods according to this invention.
BRIEF DESCRIPTION OF THE DRAWINGS
[0030] FIG. 1 shows a plan view of the tourniquet, with the second
face, showing the loop fastener material of a hook and loop
fastener system.
[0031] FIG. 2 shows a plan view of the first face of the
tourniquet, having hook-type fastener material facing up.
[0032] FIG. 3 is a depiction of the tourniquet applied over a limb
with the loop fastener end against the limb, and the hook fastener
regions facing up.
[0033] FIG. 4 depicts the further application of the tourniquet of
FIG. 3, engaging the limb with both ends wrapped beneath the
limb.
[0034] FIG. 5 shows the tourniquet of FIG. 4, with a first end
engaging the first surface of the tourniquet and the loop fastener
of the first end engaging the hook fastener region of the middle
third of the tourniquet.
[0035] FIG. 6 shows the final application of the tourniquet shown
previously in FIG. 5, with the second end engaging the first
surface of the tourniquet with the loop fastener of the second end
engaging the hook type fastener region of the first end of the
tourniquet.
DETAILED DESCRIPTION OF THE INVENTION
[0036] The products and methods of the present invention provide a
versatile tourniquet that can be used in the field by military
personnel, or in the clinical setting by medical personnel, or in a
non-combat situation where trauma hemorrhage is an issue.
[0037] In this description, by the term reversible fastening means
is meant any means, such as loop and hook fastener that allows
secure fastening of the tourniquet components, but that can be
simply and manually reversibly detached.
[0038] By tourniquet is meant any means for impeding blood flow or
blood loss at a site by compressing a vessel or series of vessels
by applying the strap, tube or other means at a region to
selectively decrease blood flow and stop bleeding.
[0039] By bi-directional is meant that the tourniquet is supplied
with two free ends, and can be applied by placing the center
against the extremity and pulling the first free end to secure it
against the center, and then pulling the opposite free end in the
opposite direction, such as to secure the tourniquet over the
extremity with resistive force from the elastic applied within the
tourniquet in both directions.
[0040] The tourniquet can be applied by medical personnel, such as
a trained physician, nurse, or emergency technician, as well as an
injured soldier, whether medically trained or a fellow soldier, in
less than 30 seconds.
[0041] Looking to FIGS. 1 and 2, the tourniquet 2 comprises a band
4 of elastic and flexible material, having a width and a length, a
first end 6 and a second end 8, and a first face 10 and second face
12. The width of the band 4 is desirably on the order of about 11/2
to 2 inches. Fabric thickness can vary, depending on the materials,
but is on the order of about 1/12 inch, down to about 1/16 inch or
less, for an appropriate fabric having the strength and elasticity
for the overall comfort and blood flow restriction requirements of
the tourniquet 2.
[0042] The length of the tourniquet 2 may vary, and multiple
tourniquets 2 can be supplied for varying applications. Where the
appendage 30 is an arm, desirable tourniquet dimensions are from
about a minimum of 24 inches to a maximum of about 30 inches.
[0043] For a leg, the dimensions are on the average order of about
30 inches minimum to a maximum of about 40 inches.
[0044] Tourniquet 2 can also be supplied in varying sizes, for
instance in sizes of small, medium, large and extra large, having
lengths of, respectively, 28 inches, 32 inches, 36 inches and 38
inches, to provide one example. Larger sizes may be required,
depending on the size and fitness of the intended populace.
[0045] A pediatric version of the tourniquet 2 can be provided with
smaller dimensions configured to be appropriate for children.
[0046] In reference to FIG. 1, the second face comprises one
component of a reversible fastening means, such as a loop-type
fastener means 14 spanning the length of the second face.
[0047] As best seen in reference to FIG. 2, at least a portion of
the first face comprises a complementary reversible fastener means,
such as a hook-type fastener means 16. These can be located at
discrete areas as attached segments of hook-type fastener means. At
a minimum, the hook-type fastener should be present at a third of
the band at the first end 20, within a third of the band at the
second end 22, and within a middle third, or middle portion 24, of
the band. Portions 20, 22 and 24 can vary in size, from a minimum
of about 2 inches up to about 9 inches or longer. The hoop-type
fastener sections 20, 22 and 24 can be secured by any conventional
means known to the art, such as machine stitched to the first face
10 of the band 4 at designated intervals. The quality of the
reversible fastener system employed should be such that the first
face 10 of the tourniquet 2 strongly adheres to the second face 12.
The hoop-type fastener sections can also be applied by stapling or
gluing, or the like, to the band 4. The overall coverage of the
hook-type fastener material 16 should leave open substantial
regions of the band 4, to allow bidirectional stretch of the band
4.
[0048] Pull tabs can be supplied 26 and 28 at the first 6 and
second ends 8, respectively, of the tourniquet 2.
[0049] In reference to FIG. 3, in application the band 4 is placed
across a limb, or appendage 30, the band 4 being adapted to
encircle the appendage 30 bi-directionally. The band 4 is provided
with a width designed to make application of the tourniquet 2
tolerable for a suitable period while the injured person is
transported. The use of a wide elastic band does not pinch, while
double stretch fabric, which pulls from opposite directions, means
the tourniquet 2 can be applied very tightly, where necessary.
[0050] As the band 4 is extended from its first end 6 to encircle
the appendage 30, the loop-type fastener means 14 at the second
face 12 engages the hook-type fastener means 16 of the first face
10, which may be at the second end 8, where the appendage 30 has a
large diameter, or, more typically, at the middle third 24 of the
tourniquet 2.
[0051] Where the band 4 is first engaged by the loop-type fastener
means 14 the second face 12 being secured to the hook-type fastener
means 24 at the middle third, the tourniquet 2 is further extended
from its second end 8 to encircle the appendage 30, and the
loop-type fastener means of the second face 12 engages the
hook-type fastener means of the first face 10 at the first end 6
previously attached over the hook material 24 at the middle
portion. The applied pressure of the tourniquet 2 is increased with
the additional hook and loop attachment where the application of
the tourniquet 2 is done in this fashion.
[0052] The tourniquet 2 provides a readily available and easily
applied, mechanism to decrease blood loss immediately after injury.
The tourniquet 2 can be applied rapidly to slow blood loss due to
vascular injury, and it is possible to apply the tourniquet 2 with
one hand, even by an injured patient, particularly when the hook
fastener material 16 and loop fastener material 14 is applied to
the uniform. The tourniquet can be adjusted with one hand, as well,
such as by changing a second end 8 while maintaining control of
hemorrhage with the first end 6 that remains adherent to the
hook-type fastener material 16. The tourniquet 2 can be applied
with bi-directional force with or without use of a hook-type anchor
already on the garment.
[0053] Rapid control of bleeding without limb-threatening ischemia
is thus possible, such that were the tourniquet 2 supplied to every
soldier or emergency personnel, it could result in decreased
mortality, reduction in the need for transfusion (or the amount
thereof), and finally, lessen the risk of amputation for field or
emergency situations. In the event of trauma to an appendage, the
tourniquet 2 can typically be applied within 30 seconds to control
and decrease blood loss.
[0054] The simple band 4 allows various levels of control of
bleeding, and without causing greater injury. The tourniquet 2 is
light in weight, packs down to a very small package, and presents
no additional risk from heat, such as the risk of flammability as
is found in rubber tubing tourniquets. Thus, the tourniquet 2 can
always be within easy reach and readily deployed.
[0055] The tourniquet 2 is also adjustable, in that it is as easy
to secure as it is to release, so that quick adjustments can be
made, such as for decreasing or increasing the level of tightness,
and thus pressure. The ready and simple method of applying the
tourniquet 2 permits various levels of pressure, partly due to the
use of an elastic form of bandage 4, and as such the blood flow
decrease may be partial to substantially complete. The method can
be applied to decrease the distal pulse/blood flow a significant
amount, by about 50, 60 or 70 percent, or more, as determined by
Doppler flow measurements, though the tourniquet 2 should not,
however, be so occlusive that ischemia results from total
compression blood flow.
[0056] The tourniquet may also be permanently affixed to a garment
at a permanent attachment point, such as by stapling, gluing and
sewing the tourniquet at a desired or preferred location, such as a
region on the uniform corresponding to an upper or lower
extremity.
[0057] The tourniquet 2 can be supplied as part of emergency kits,
particularly kits designed for vehicles, hiking, camping, household
emergencies and the like.
[0058] A disc may be provided as part of such a kit, comprising a
substantially cylindrical, hard, non-compressible material. The
disc provides a surface for contacting the appendage 20, and
connected to the band by having hook-type fastener applied to a
surface opposite the surface contacting the appendage.
[0059] While this invention has been described in conjunction with
the specific embodiments outlined above, it is evident that many
alternatives, modifications and variations will be apparent to
those skilled in the art. Accordingly, the preferred embodiments of
the invention, as set forth above, are intended to be illustrative,
not limiting. Various changes may be made without departing from
the spirit and scope of this invention.
* * * * *